智能3D/4D盆底超声在高龄产妇产后早期盆底改变评估及盆底功能障碍性疾病诊断中的应用价值  

Application value of intelligent 3D/4D pelvic floor ultrasound in the assessment of early postpartum changes in the pelvic floor and the diagnosis of pelvic floor dysfunctional diseases in elderly women

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作  者:马新乐 郑志硕 徐杰 李锋 MA Xinle;ZHENG Zhishuo;XU Jie;LI Feng(Department of Ultrasound,Xinxiang Central Hospital/Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,Henan Province,China;Department of Medical Imaging,Xinxiang Central Hospital/Fourth Clinical College of Xinxiang Medical University,Xinxiang 453000,Henan Province,China)

机构地区:[1]新乡市中心医院/新乡医学院第四临床学院超声科一,河南新乡453000 [2]新乡市中心医院/新乡医学院第四临床学院影像科,河南新乡453000

出  处:《新乡医学院学报》2025年第3期202-207,共6页Journal of Xinxiang Medical University

基  金:河南省医学科技攻关计划联合共建项目(编号:LHGJ20240848)。

摘  要:目的探讨智能3D/4D盆底超声对高龄产妇产后早期盆底改变的评估作用及盆底功能障碍性疾病的诊断价值。方法按照1:1配对原则,选择2021年5月至2024年6月在新乡市中心医院妇产科门诊就诊的产后6~8周高龄产妇102例(≥35岁,高龄组)及适龄产妇102例(20~34岁,非高龄组)作为研究对象。比较2组产妇孕前体质量指数(BMI)、孕期增加体质量、分娩孕周、民族、孕史、新生儿性别、新生儿体质量、新生儿头围及是否无痛分娩、会阴侧切等一般资料;应用智能3D/4D盆底超声检查产后早期盆底改变;比较2组产妇产后6~8周盆底功能障碍性疾病发生率,应用Kappa指数分析智能3D/4D盆底超声诊断产后盆底功能障碍性疾病与临床实际诊断的一致性。结果高龄组产妇的孕前BMI、孕期增加体质量、分娩孕周、民族、孕史、新生儿性别、新生儿体质量、新生儿头围、无痛分娩、会阴侧切与非高龄组比较差异无统计学意义(P>0.05)。高龄组产妇的静息状态下尿道倾斜角、膀胱尿道后角与非高龄组比较差异无统计学意义(P>0.05);高龄组产妇的静息状态下肛提肌裂孔面积、前后径、左右径大于非高龄组(P<0.05);高龄组产妇的最大Valsalva动作状态尿道倾斜角、膀胱尿道后角及肛提肌裂孔面积、前后径、左右径大于非高龄组(P<0.05)。高龄组产后6~8周盆底功能障碍性疾病总发生率显著高于非高龄组(χ^(2)=8.971,P<0.05)。一致性分析结果显示,智能3D/4D盆底超声诊断产后盆底功能障碍性疾病与临床实际的一致性为98.53%,Kappa值为0.922(95%置信区间:0.785~1.059,P<0.05)。结论高龄产妇产后早期盆底结构、功能异常改变较非高龄产妇严重,3D/4D盆底超声参数可定量评估高龄产妇产后盆底肌结构、功能改变,对盆底功能障碍性疾病具有一定诊断价值。Objective To explore the role of intelligent 3D/4D pelvic floor ultrasound in evaluating elderly postpartum changes in the pelvic floor and diagnosing pelvic floor dysfunctional diseases in elderly women.Methods A total of 102 women aged≥35(elderly group)and 102 women aged 20-34(non-elderly group)who had visited the Obstetrics and Gynecology Department of Xinxiang Central Hospital from May 2021 to June 2024 were selected at a pairing ratio of 1 GA6FA 1 six to eight weeks after delivery.The general information such as pre-pregnancy body mass index(BMI),increased body mass during pregnancy,gestational week at delivery,ethnicity,pregnancy history,newborn gender,newborn body mass,newborn head circumference,painless delivery,and episiotomy were compared between the two groups.Early postpartum changes in the pelvic floor were examined by intelligent 3D/4D pelvic floor ultrasound.The incidence of pelvic floor dysfunctional diseases was compared between the two groups 6-8 weeks after delivery,and the Kappa index was used to analyze the consistency between intelligent 3D/4D pelvic floor ultrasound and clinical diagnoses of postpartum pelvic floor dysfunctional diseases.Results There was no significant difference in pre-pregnancy BMI,increased body mass during pregnancy,gestational week at delivery,ethnicity,pregnancy history,newborn gender,newborn body mass,newborn head circumference,painless delivery,and episiotomy between the elderly and non-elderly groups(P>0.05).There was no significant difference in the resting urethral inclination angle and bladder urethral posterior angle between the elderly and non-elderly groups(P>0.05).The resting levator ani hiatus area,anteroposterior diameter,and lateral diameter in the elderly group were higher than those in the non-elderly group(P<0.05).The urethral inclination angle,bladder urethral posterior angle,and the area,anteroposterior diameter,and lateral diameter of the levator ani hiatus in the elderly group during the maximum Valsalva maneuver were higher than those in the no

关 键 词:智能3D/4D盆底超声 产妇 盆底改变 盆底功能障碍 

分 类 号:R445.1[医药卫生—影像医学与核医学]

 

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